Improving Patient Care Through Objective Monitoring of At-Home Repetitive Ritual Behaviors in Obsessive-Compulsive Disorder

项目摘要 强迫症(OCD)的特征是有侵扰性的、痛苦的想法(强迫症) 对个人感到被迫执行重复行为的反应(强迫症)，这是 为减少患者经历的急性痛苦而实施的，但这会使强迫症永久化 症状。有效的治疗需要准确报告强迫行为，而一个关键挑战是 患者经常向提供者虚报自己的行为，因为短期的焦虑缓解带来了 通过参与强迫比抵制强迫的长期挑战更可取，以便 治疗这种情况，从而削弱了这些治疗的效果。可利用的客观监测工具， 例如心电监测器，可以检测到焦虑增加的时期，而戴在手腕上的设备 可以监测诸如拉头发等行为，但它们在检测洗手方面的准确性有限 强迫症在强迫症中很常见，因此不适用于这些患者。总体目标 通过开发和测试技术方案的可行性来解决这一关键差距 创新涉及一种新的可穿戴智能戒指录音方式，它不受干扰，并提供更多 客观测量患者和他们的治疗师的强迫行为，以便显著改善 强迫症的治疗效果。这个戒指装置有几个创新：它是一个智能戒指(1)，可以 检测清洗剂如水或酒精(2)以及重复行为(3)，以便客观地监控 强迫性洗手或其他仪式性活动(4)。此信息将被发送到仪表板(5)，其中 实时日志，让治疗师客观地测量戒指检测到的行为数量，并监控磨损- 时间依从性(6)。这项建议的具体目标是：1)优化可接受性、可行性和实用性 RING设备及其相关的智能手机应用程序/Web界面通过迭代的1：1反馈 这项技术的用户(患者/提供者)；2)开发活动记录智能环原型，并 基于AIM 1调查结果的关联软件系统。智能戒指将是一个微型系统，可以记录 运动、温度和湿度。它将在佩戴时进行记录并无线下载数据，与 将与云存储形态同步的智能手机应用程序；3)进行多阶段可接受性， 可行性和实验评估方案首先针对健康成人，然后针对强迫症患者， 随后对临床医生进行了深入的反馈采访。先进医疗电子拥有广泛的 在生物医学开发方面有经验，学术合作伙伴(Asnaani，Gooneratne)拥有强迫症方面的专业知识， 实验方法、移动健康、生物医学创业，以及之前成功的记录 就以前的科技成果转化项目资助的研究和建议开展合作。如果成功，该项目将为患者提供 和医疗保健提供者提供非侵入性的、更准确的工具来实时监控典型的 强迫行为，以显著提高一线治疗强迫症的疗效。

Project Summary Obsessive-compulsive disorder (OCD) is characterized by intrusive, distressing thoughts (obsessions) in response to which an individual feels compelled to perform a repetitive behavior (compulsions), which are performed in order to reduce the acute distress experienced by the patient but which perpetuate OCD symptoms. Effective treatment requires accurate reporting of compulsive behaviors, and a key challenge is that patients often underreport their behaviors to their providers because the short-term anxiety relief brought about by engaging in the compulsion is preferable to the long-term challenge of resisting the compulsions in order to treat the condition, thereby impairing the efficacy of these treatments. Available objective monitoring tools, such as electrocardiogram (ECG) monitors, can detect periods of increased anxiety, while wrist-worn devices can monitor behaviors such as hair pulling, but they have limited accuracy for detecting hand-washing compulsions which are common in OCD and are thus not indicated for use in these patients. The overall goals of this Phase 1 STTR are to address this key gap by developing and testing the feasibility of a technological innovation involving a novel wearable smart-ring recording modality that is unintrusive and provides a more objective measure of compulsive behavior to both patients and their therapists in order to appreciably improve the effectiveness of OCD treatment. This ring device offers several innovations: It is a smart ring (1) that can detect cleaning agents like water or alcohol (2) as well as repetitive behaviors (3) in order to objectively monitor obsessive hand-washing or other ritualistic events (4). This information would be sent to a dashboard (5) with a real-time log for a therapist to objectively measure the number of behaviors the ring detects and monitor wear- time compliance (6). Specific aims of this proposal are to: 1) Optimize acceptability, feasibility and utility of the ring device and its associated smartphone app/web interface through iterative 1:1 feedback from the range of users of this technology (patients/providers); 2) Develop a prototype activity recording smart ring and associated software system based on Aim 1 findings. The smart ring will be a miniature system that records movement, temperature, and wetness. It will record while worn and wirelessly download data, pairing with a smartphone app which will sync with a cloud storage modality; 3) Conduct a multi-phased acceptability, feasibility and experimental assessment protocol first with healthy adults and then with patients with OCD, followed by in-depth feedback interviews with clinicians. Advanced Medical Electronics has extensive experience in biomedical development, and academic partners (Asnaani, Gooneratne) have expertise in OCD, experimental methodology, mHealth, biomedical entrepreneurship, along with a prior track record of successful collaboration on previous STTR funded studies and proposals. If successful, this project will provide patients and health care providers with an unintrusive and more accurate tool for real-time monitoring of typical compulsive behaviors in order to appreciably improve the efficacy of front-line treatments for OCD.